WASHINGTON (AP) _ President Bush on Friday ordered members of the military serving in high-risk areas to take the smallpox vaccine and said he will be inoculated as well. But he said for most people, the risk of bioterrorism doesn't warrant vaccinations.
``Small pox is a serious disease and we know that our enemies are trying to inflict serious harm,'' the president said. ``Yet there is no evidence that smallpox imminently threatens this country.''
Still, he announced the first smallpox vaccine program in a generation because the Sept. 11 attacks have forced America to evaluate ``old threats in a new light.''
Bush said the vaccine will be made available to civilian health care workers who would come in contact with the first victims of a biological attack. Experts say that group numbers about 450,000. Americans working in certain embassies overseas also will be offered the shots, a White House fact sheet said.
With war in Iraq a growing possibility, Bush said U.S. troops in ``high-risk parts of the world'' will be given the inoculation. Experts say a half-million troops could be eligible. He said there is ``a small risk'' of serious health problems with the vaccine.
``As commander in chief, I do not believe I can ask others to accept this risk unless I am willing do to the same,'' Bush said. ``Therefore, I will receive the vaccine along with our military.''
After weeks of agonizing debate, Bush opted against a nationwide campaign to educate _ and eventually inoculate _ the entire country, though that step could come later.
``Given the current level of threat and the inherent health risks of the vaccine, we have decided not to initiate a broader vaccination program for all Americans at this time,'' Bush said. ``Neither my family nor my staff will be receiving the vaccine because our health and national security experts do not believe a vaccination is necessary for the general public.''
The government will make plans in case a broader vaccination program should become necessary in the future, Bush said.
``There may be some citizens, however, who insist on being vaccinated now. Our public health agencies will work to accommodate them,'' he said.
``But that is not our recommendation at this time.''
People who want the vaccine can currently get an unlicensed version through a clinical trial process. But Bush said that for the people who ``insist on being vaccinated now,'' his administration is devising a process to make unlicensed vaccines available to them in 2003. By 2004, there will be enough licensed vaccine so that every American without disqualifying conditions can get it.
In previewing Bush's remarks, aides had suggested Bush would take a more expansive view toward vaccines for the public.
The deadly disease, eradicated 22 years ago, is inspiring new dread as a terror weapon.
Among those who shouldn't get it are people with compromised immune systems, including cancer patients, organ transplant recipients and people with HIV; pregnant women; and people with a history of eczema.
Smallpox was declared wiped out in 1980, but experts fear that it could be used by hostile nations or terrorist groups in an attack. Intelligence experts believe that four nations, including Iraq, have unauthorized stocks of the virus.
Bush deliberated for months, weighing the dangers of the disease against the risks associated with the vaccine.
Based on studies from the 1960s, experts estimate that 15 out of every 1 million people vaccinated for the first time will face life-threatening complications, and one or two will die. Reactions are less common for those being revaccinated.
Using these data, vaccinating the nation could lead to nearly 3,000 life-threatening complications and at least 170 deaths.
But the administration concluded that the government could not make the vaccine available to some people and not others who want it.
Routine smallpox vaccinations ended in the United States in 1972, meaning nearly half the population is without any protection from the virus. Health officials aren't sure whether those vaccinated decades ago are still protected from the disease.
The Defense Department may meet some resistance in vaccinating all military members, if its experience with the anthrax vaccine is any indication. Some military personnel believed the anthrax vaccine caused health problems, and hundreds were forced from the armed forces after refusing to take it.